Provider Demographics
NPI:1255735262
Name:CHING, LOLA
Entity type:Individual
Prefix:
First Name:LOLA
Middle Name:
Last Name:CHING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77-925 WAIAEA ROAD
Mailing Address - Street 2:
Mailing Address - City:HOLUALOA
Mailing Address - State:HI
Mailing Address - Zip Code:96725
Mailing Address - Country:US
Mailing Address - Phone:808-315-8055
Mailing Address - Fax:
Practice Address - Street 1:77-925 WAIAEA RD
Practice Address - Street 2:
Practice Address - City:HOLUALOA
Practice Address - State:HI
Practice Address - Zip Code:96725
Practice Address - Country:US
Practice Address - Phone:808-315-8055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-20
Last Update Date:2014-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI6906225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist